U.S. - White House warns Christie and Cuomo over Ebola quarantine rules

Dominic Rushe and Lauren Gambino

White House officials warned the governors of New York and New Jersey of the “unintended consequences” of quarantining all medical workers returning from west Africa, as a political crisis deepened on Sunday over how to counter public fears about the spread of Ebola in the US.

Amid a barrage of criticism from aid organisations, medical experts and the mayor of New York, the governor of New Jersey, Chris Christie, and his New York counterpart, Andrew Cuomo, have defended their plans, which provide for the mandatory 21-day quarantine of anyone returning from west Africa after direct contact with people suffering from Ebola.

But on Sunday evening Cuomo struck a less hardline tone, saying returning healthcare workers could be quarantined at home and receive twice-daily monitoring from medical professionals. The state will also compensate for any lost wages.

Cuomo also referred to healthcare workers returning from Africa as “heroes”, and said his administration would encourage more to volunteer.

Earlier in the day in New Jersey, Kaci Hickox, a nurse who was detained on Friday despite testing negative for Ebola, described her treatment as “inhumane” and said she had been made to feel like a criminal.

The White House made it clear that it objected to the hurried introduction of “policies not grounded in science”.

The tougher rules were introduced hurriedly on Friday by Christie and Cuomo after it emerged that a New York doctor, Craig Spencer, had moved widely around the city in the days before he tested positive for Ebola.

Spencer, who worked for Doctors Without Borders in Guinea, is now in isolation at Bellevue Hospital. Hickox was stopped at Newark airport in New Jersey just as the new rules were announced.

On Sunday evening Bill de Blasio, the mayor of New York City, hit out strongly against her treatment. “The problem is this hero, having come back from the front, having done the right thing, was treated with disrespect, was treated with a sense that she had done something wrong when she hadn’t,” he said.

De Blasio, who was speaking at a press conference at Bellevue, added: “We respect the right of each governor to make decisions that they think are right for their people. But we have to think how we treat the people who are doing this noble work and we must show them respect and consideration at all times. And we owe [Hickox] better than that and all the people who do this work better than that.”

The White House indicated that it was urgently reviewing the federal guidelines for returning healthcare workers, “recognising that these medical professionals’ selfless efforts to fight this disease on the front lines will be critical to bringing this epidemic under control, the only way to eliminate the risk of additional cases here at home”.

“We have let the governors of New York, New Jersey, and others states know that we have concerns with the unintended consequences of policies not grounded in science may have on efforts to combat Ebola at its source in West Africa,” an administration official said.

The governors’ moves created another political crisis for the Obama administration, which is already facing criticism of its handling of the Ebola crisis in the run up to the midterm elections.

Samantha Power, the US ambassador to the United Nations, on Sunday became the highest-ranked administration official to officially comment on the crisis. She told NBC: “We need to make sure [returning healthcare workers] are treated like conquering heroes and not in any other way.”

Power, who was in Guinea’s capital Conakry on the first leg of a tour through the three West African nations hardest hit by the epidemic, said: “All of us need to make clear what these health workers mean to us and how much we value their services, how much we value their contribution.”

In New Jersey, Hickox, who returned from a stint working for Doctors Without Borders in Sierra Leone, appointed a lawyer to free her and called her treatment “inhumane” and “poorly planned”.

Dr Anthony Fauci, the director of the National Institute for Allergies and Infectious Disease, said quarantining health workers could have the unintended consequence of stopping US aid workers from tackling the disease at its source in West Africa.

“There’s a big, big difference between completely confining somebody so that they can’t even get outside and doing the appropriate monitoring based on scientific evidence,” he said on CNN. “The harm is that it is totally disruptive of their life. We want them to go because they are helping us to protect America to be over there.”

Ebola cannot be transmitted until someone with the disease begins to display symptoms; even then it is only transmitted through direct contact with bodily fluids.

A spokesman for Doctors Without Borders said a total of 52 people from the US had worked with the organisation in west Africa on the Ebola response since it began in March. The spokesman said 31 Americans were currently working in West Africa, with 20 due to return sometime in the next four weeks.

A spokesman for SIM, Palmer Holt, said the international missionary organisation had one American doctor in Liberia, “who is planning to return to the States soon, but if he has to undergo mandatory quarantine, he may not be able to do that, as his plan is to do a brief visit and then quickly return.”

Christie has so far defended his position, believing he has public opinion on his side. Illinois followed New York and New Jersey in introducing a 21-day quarantine on Friday and on Saturday Florida announced three weeks of testing for aid workers returning from affected areas. On Sunday, Christie said he expected quarantine of workers to become “national policy sooner rather than later”.

The new policies infuriated city officials in New York, who had drawn up meticulous plans to deal with potential Ebola patients in the wake of criticisms of the way Dallas officials handled the case of Thomas Eric Duncan, the first person to be given a diagnosis of Ebola in the US, whose treatment was widely seen to have been bungled.

Duncan died on 8 October; two nurses who treated him contracted the disease and have since recovered.

New federal rules were also set to come into force Monday. Those plans and those prepared by New York have been thrown into disarray by the governors’ surprise moves.

De Blasio said New York was “fully prepared to handle the crisis”, and added: “There is no reason for New Yorkers to be alarmed. This is a very difficult disease to contract.

“It takes an extraordinary amount of direct and physical contact to contract this disease.”

From Monday, the Centers for Disease Control and Prevention will require any traveler returning from the affected West African countries to report their temperatures to their local health authorities. Travelers from Guinea, Liberia and Sierra Leone will be required to report every day for the 21 days following their departure from West Africa, the length of time in which Ebola can remain dormant.

They will also be required to tell officials where they will be staying in the three weeks after they arrive and to hand over a list of relatives.